0506U prior authorization | Premera Blue Cross of Washington

0506U, Gastroenterology (Barrett's esophagus), esophageal cells, DNA methylation analysis by next-generation sequencing of at least 89 differentially methylated genomic regions, algorithm reported as likelihood for Barrett's esophagus, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0506U
Description: Gastroenterology (Barrett's esophagus), esophageal cells, DNA methylation analysis by next-generation sequencing of at least 89 differentially methylated genomic regions, algorithm reported as likelihood for Barrett's esophagus
Source: Clinical Review by Code List PBCWA, Pg 102 Original policy

Premera Blue Cross of Washington prior authorization

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